Healthcare Provider Details
I. General information
NPI: 1093285140
Provider Name (Legal Business Name): MEGAN VOSSWINKEL CNM, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/03/2018
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2555 N DR MARTIN LUTHER KING DR
MILWAUKEE WI
53212-2709
US
IV. Provider business mailing address
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE WI
53212-2709
US
V. Phone/Fax
- Phone: 414-372-8080
- Fax: 414-562-8447
- Phone: 414-267-2641
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 148976-32 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | 9273-33 |
| License Number State | WI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 9273-33 |
| License Number State | WI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 225823-30 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: